CAOHC Medical Referral Criteria and Follow-up 2

Question 1

A worker's annual audiogram reveals significant asymmetric hearing loss — the right ear is substantially worse than the left with no change from last year. What is the most appropriate action?

Accepted Answer

Refer the worker to a physician due to the risk of retrocochlear pathology

Answer

Significant unexplained asymmetric hearing loss can indicate retrocochlear pathology such as acoustic neuroma, requiring physician evaluation even without a confirmed STS.

Question 2

A worker reports a sudden, total loss of hearing in one ear that was not present at their last annual audiogram six months ago. What is the most urgent action?

Accepted Answer

Refer the worker urgently to a physician for evaluation of possible sudden sensorineural hearing loss

Answer

Sudden sensorineural hearing loss is a medical emergency requiring urgent physician evaluation since prompt treatment can improve outcomes.

Question 3

Under OSHA 29 CFR 1910.95, at whose expense must physician or audiologist referrals be provided when a worker has a confirmed STS?

Accepted Answer

The employer, at no cost to the worker

Answer

OSHA mandates that referrals resulting from STS determinations must be provided at no cost to the employee — the employer bears the expense.

Question 4

Which type of audiometric finding would most warrant referral due to suspected non-noise etiology?

Accepted Answer

A progressive low-frequency hearing loss pattern in both ears

Answer

Progressive low-frequency bilateral hearing loss is not typical of noise-induced hearing loss and suggests a non-noise etiology such as Meniere's disease or endolymphatic hydrops, warranting physician referral.

Question 5

Which of the following should NOT typically appear in a referral letter sent from an OHC to a physician?

Accepted Answer

The worker's wage, salary, and benefit information

Answer

A medical referral letter should include clinically relevant information such as audiometric history and noise exposure data, but salary and benefits are not medically pertinent.

CAOHC - Council for Accreditation in Occupational Hearing Conservation Practice Test

CAOHC - Council for Accreditation in Occupational Hearing Conservation Practice Test

CAOHC Medical Referral Criteria and Follow-up 2